Pectoralis minor muscle transfer for unilateral facial palsy reanimation: An experience of 35 years and 637 cases

• Published in: Journal of plastic, reconstructive & aesthetic surgery Vol. 65; no. 7; pp. 845 - 850
• Main Authors: Harrison, Douglas H, Grobbelaar, Adriaan O
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 01.07.2012; Elsevier
• Subjects: Adolescent; Adult; Biological and medical sciences; Child; Child, Preschool; Ear, auditive nerve, cochleovestibular tract, facial nerve: diseases, semeiology; Facial Muscles - innervation; Facial Muscles - physiopathology; Facial Paralysis - physiopathology; Facial Paralysis - surgery; Facial reanimation; Female; Free functional muscle transfer; Humans; Male; Medical sciences; Middle Aged; Nerve Transfer - methods; Nervous system (semeiology, syndromes); Nervous system as a whole; Neurology; Non tumoral diseases; Otorhinolaryngology. Stomatology; Pectoralis Muscles - transplantation; Plastic Surgery; Prospective Studies; Reconstructive Surgical Procedures; Reoperation; Revisional procedures; Smiling; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Tightness; Treatment Outcome; Tightness; Free functional muscle transfer; Facial reanimation; Revisional procedures; Nervous system diseases; Motor system disorder; Facial paralysis; Facial nerve; Pectoralis minor musculus; Cranial nerve disease; Treatment; Surgery; Unilateral; ENT disease; Neurological disorder; Face
• ISSN: 1748-6815; 1878-0539
• DOI: 10.1016/j.bjps.2012.01.024

Summary Background Free functional muscle transfers are often the treatment of choice for facial reanimation. We describe our experience with 637 cases over a 35-year period. Methods Data was collected prospectively on all case undergoing functional muscle transfer for unilateral facial paralysis. Results were judged by the operating surgeon and an Independent panel of four observers. Results 354 patients had an excellent result as judged by the surgeon. An independent panel rated patients to have a significant change pre- and post-operatively comparing their Hay’s scores ( p  < 0.001, t -test). 27.2% of patients required revisional procedures. 13.3% of patients developed late onset tightness of the transferred muscle. Conclusions Facial reanimation with functional muscle transfers is a complex procedure and provides a significant improvement for the patient to display humour and emotion.